This study is a logical follow up of previous KCE reports about quality of care, namely report 41 about clinical quality indicators in hospitals and report 76 about quality promotion in general practice ... [more ▼]

This study is a logical follow up of previous KCE reports about quality of care, namely report 41 about clinical quality indicators in hospitals and report 76 about quality promotion in general practice. Pay for Performance (P4P) or Pay for Quality initiatives (P4Q), who concentrate exclusively on the quality constituent of performance, establishes a direct correlation between the payment and the outcomes, assessed by structure, process and\or outcome indicators). P4Q initiative arouses an increasing interest, abroad as in our own country. However, the future Belgian initiatives will be able to reach their objective if they are based on what can be learned from experiences led abroad and on a theoretical frame fitting to the Belgian context. Accordingly, the present report will answer the following research questions: 1. What can be learned from the international P4Q models about: • Assessment: what are the benefits and the unintended consequences of the P4Q programs? • The concept and the implementation: which theoretical framework can be applied to the Belgian health care system; how should be conceived the financial incentives; what are the determining success factors? 2. What are the essential conditions required to apply the international P4Q models or add a P4Q constituent to the Belgian quality experiences? • What are the current initiatives in Belgium? Are there proofs of their impact on quality of care? • To what extent are financial planning, databases and other current tools (recommendations of good practice, quality indicators) adequate to implement a P4Q program in the Belgian context of health care? What are the determining factors for success or failure in the implementation of these programs? [less ▲]